Kennedy A W, Hart W R
Department of Gynecology, Cleveland Clinic Foundation, Ohio 44195, USA.
Cancer. 1996 Jul 15;78(2):278-86. doi: 10.1002/(SICI)1097-0142(19960715)78:2<278::AID-CNCR14>3.0.CO;2-T.
The clinical outcome of patients with ovarian serous tumors of low malignant potential (LMP) remains controversial, especially for those with extraovarian disease. We retrospectively reviewed our experience to study this question further, to assess the safety of conservative management of patients with limited disease, and to determine whether exophytic ovarian surface tumor was predictive of tumor recurrence.
The clinical and pathologic records of 76 patients with ovarian serous LMP tumors accessioned at the Cleveland Clinic Foundation from 1979 to 1990 were reviewed. International Federation of Gynecology and Obstetrics (FIGO) staging was retrospectively assigned, follow-up information obtained, and clinicopathologic correlations made.
An exophytic ovarian surface component was present in 39 of 76 patients (51%). Stage II or III disease was present in 28 of 74 staged patients (38%). Follow-up information was available on 66 patients, ranging from 8 to 264 months (mean, 99 months). Twenty-five patients of 66 patients with follow-up information (38%) received adjuvant therapy. Only 1 patient (1.5%) developed progressive disease; she died of widespread invasive serous carcinoma. Two of 18 conservatively managed patients (11%) developed "recurrent" disease, including 1 patient with a second primary serous LMP tumor of the preserved ovary and 1 patient with an incidentally discovered microscopic serosal implant. There were no other recurrences in the study group, which included four patients with stromal microinvasion and one with lymph node involvement.
The long term outcome of serous LMP tumors is extremely favorable. Exophytic ovarian surface tumor did not serve as a predictor for subsequent peritoneal implants. Conservative surgical management in young patients with localized disease is supported and the use of adjuvant therapy in the initial management of patients with advanced tumors is further questioned.
低恶性潜能卵巢浆液性肿瘤（LMP）患者的临床结局仍存在争议，尤其是那些伴有卵巢外病变的患者。我们回顾性分析了我们的经验，以进一步研究这个问题，评估疾病局限患者保守治疗的安全性，并确定外生性卵巢表面肿瘤是否可预测肿瘤复发。
回顾了1979年至1990年在克利夫兰诊所基金会登记的76例卵巢浆液性LMP肿瘤患者的临床和病理记录。回顾性地进行国际妇产科联合会（FIGO）分期，获取随访信息，并进行临床病理相关性分析。
76例患者中有39例（51%）存在外生性卵巢表面成分。74例分期患者中有28例（38%）为II期或III期疾病。66例患者有随访信息，随访时间为8至264个月（平均99个月）。66例有随访信息的患者中有25例（38%）接受了辅助治疗。仅1例患者（1.5%）出现疾病进展；她死于广泛侵袭性浆液性癌。18例接受保守治疗的患者中有2例（11%）出现“复发”疾病，其中1例为保留卵巢的第二原发性浆液性LMP肿瘤，1例为偶然发现的微小浆膜种植。研究组中无其他复发情况，研究组包括4例有间质微浸润的患者和1例有淋巴结受累的患者。
浆液性LMP肿瘤的长期结局非常好。外生性卵巢表面肿瘤不能作为后续腹膜种植的预测指标。支持对年轻的局限性疾病患者进行保守手术治疗，进一步质疑在晚期肿瘤患者初始治疗中使用辅助治疗。
